When people think of allergies, many think of Spring pollen allergies. However, allergy sufferers are not confined only to Springtime. In my childhood, at the beginning of every school year, I would bring a bunch of Kleenex with me to stop my nose from constantly running. This would begin mid August through September. I was certain I was allergic to school and should just stay home. No, mom gave me the Kleenex and allergy shots. I was allergic to ragweed pollen which is prevalent now, and around Halloween, leaf mold.

Now I am a pulmonologist (lung doctor) working in Fredericksburg and I have allergies myself (as does most of Fredericksburg).

What are allergies and what can we do about them? Allergies are our body's response to perceived invaders from our environment. Specifically, allergies are part of our body's immune system which involves immunoglobin E (or IgE) antibody formation after exposure to an allergen (something causing this response). Most allergies are probably genetically based. Initially, a person becomes "sensitized" to an allergen then upon re-exposure, the body's immune system is triggered.. This response may be in the form of an inconvenient runny nose, or a medical emergency such as shock (low blood pressure).

What I will do in the next few months is discuss some common allergy problems I see and discuss some remedies that may be helpful in everyday living. Topics I think are interesting are: allergic rhinnitis (runny nose due to allergies), food and drug allergies, bee and wasp stings, and allergy and asthma.

Allergic rhinnitis (AR) is a runny nose after exposure to an allergen (pollen, house dust mites, animal dander, mold and mildew). One out of every five adults has some form of allergies and if one or both parents have allergies, their offspring will have a 50% chance of having allergies, too (thanks, Mom and Dad). AR can be divided into seasonal (like ragweed season) or perennial (year round). Usually seasonal AR is fairly easy to recognize. Every spring, your eyes water and your nose becomes congested and itches. If there is no seasonal variation, perennial rhinnitis (PR) may be your problem. PR tends to be related to constant exposures to allergens such as pets (birds are the worst, then cats and dogs-- goldfish are ok), molds and mildews (check crawlspaces for water and mold) and house dust mites (in all of our bedding, pillows and box springs--now try to get some sleep !)

Treatments come in many different forms:
Allergy shots have been available for over 100 years, administered by an allergist. They work, but they take a year to begin working and 2-5 years to get the best results.
For those of us who can't wait, there are several drugs available. The best are nasal steroids (Nasacort, Nasonex, Rhinocort, Flonase etc.). The major problem with nasal steroids is patient compliance, people don't like taking nose sprays. These are NOT anabolic steroids and you may take them without jeopardizing eligibility for the Tour de France.
Antihistamines are a great choice for AR. The new antihistamines (Zyrtec, Allegra and Claritin/Clarinex) work almost as well as the older antihistamines (Benadryl, Chlor-Trimeton) but are non-sedating so you can then stay awake for class if you want to.
Lastly, leukotriene receptor antagonists such as Singulair and Accolate offer some decongestant properties.

Next time, how to deal with mold and mildews, pet dander and house dust mites!

Jeff Ream is a pulmonologist, father of three, practicing in Fredericksburg at both Mary Washington Hospital and 521 Park Hill Drive. Phone number (540)899-1615.